Clinical Nurse Manager

Job Description

Job Description

Job description

We are currently looking for a Registered Nurse (RN) who will help us with daily operations and serve as a clinical coordinator/manager for our home health agency.

Position Summary:

• The RN will function as a Clinical and Admissions Coordinator.

• The nurse will help manage the daily operations of the agency and coordinate patient intake/ admissions.

• Reviews and coordinates all needed clinical information before patient admission to ensure the perfect pathway for new patients.

• Communicate with Nurse manager and teams regarding new patients.

Current RN License required

Qualifications:

Educational :

• RN Licensed to practice in Massachusetts.

• Graduate of a School of Nursing or College with an accredited RN Program.

Experience:

• Minimum 2 years related experience including home healthcare, medical/surgical, and community health and/or experience with a managed care organization.

• Previous intake, liaison or discharge planning experience is preferred.

• Knowledge of home health care standards and practices (preferred)

• Knowledge of medical terminology and treatment modalities of patient diagnoses required

• Knowledge of Medicare, Medicaid and other insurance payers.

Functions & Responsibilities:

· Coordinates referrals from hospitals, physicians, other health facilities, community agencies, and patients and their families between patient account center and the clinical nursing team.

· Demonstrates advanced knowledge of home health and Hospice eligibility criteria and COP for purposes of appropriate referral coordination.

· Prepare and maintain on-call schedule and serve as a back up for on-call

· Assist with marketing activities as required.

· Serve as a liaison for branch office when dealing with corporate on; billing, payroll and collection resolution.

· Primary responsibility for all training (new hires and existing employees). This includes Staffing Coordinators and Administrative Support Coordinators, specific to their job descriptions.

· Responsible for tracking and reporting all prior approvals for Medicaid and Managed Care contracts and to coordinate all activities with Corporate Billing personnel.

· Responsible for intake of all private pay and insurance cases along with all appropriate paperwork.

· Serve as a liaison between nursing staff, coordinators and corporate regarding client care and payment issues.

· Responsible for coordinating weekly staff meetings with all office staff.

· On a weekly basis review non-compliance reports and remove from cases, all field personnel who are out of compliance with regulatory requirements.

· Participate as required in contract meetings, team meetings and client case conferences.

· Communicates with the patient’s physician, family and others to obtain complete referral information and to assist in organizing resources necessary for patient care prior to admission.

· Triages incoming clinical phone calls from patient’s families and referral sources.

· Collaborates with clinical staff and evaluates patient information/clinical documentation to ensure patient is appropriate for home health care and will be services on the perfect pathway to optimize clinical care.

· Performs thorough clinical assessment of the referral and ensure patient is placed on the perfect pathway and coordinates back with referral source any recommendations.

· Makes preliminary arrangements for any special medical supplies/equipment or for other community services that a patient may require upon admission.

· Communicates with appropriate pod staff to share patient referral information.

· Communicates with pod staff regarding daily capacity. Able to coordinate/communicate that with the patient admissions coordinator.

· Documents and obtains MD orders as appropriate.

· Provides support for Utilization Review and Quality Assurance activities as requested.

· Maintains records and reports of referrals and admissions.

· Provides support for the process of obtaining insurance verification and initial authorization for services.

· Communicate with referral sources, families, and physicians to confirm admission.

· Provides for special customer service referral arrangements with hospitals and physician offices and works closely with liaison staff.

· Participates in the orientation of new staff.

· Assists with liaison functions as necessary.

· Actively participates in activities to attain department goals.

· Participates in ICD-9 coding of referrals.

· Assists in referral entry as needed.

· Upholds the compliance objectives, policies, and procedures of the Foundation and Subsidiaries.

· Performs other related duties of a similar nature and complexity as directed.

Job Types: Full-time, Part-time, PRN, Per diem

Pay: $50.00 - $60.00 per hour

Expected hours: 24 – 40 per week

Benefits:

• Flexible schedule

• Paid time off

Medical Specialty:

• Geriatrics

• Home Health

• Medical-Surgical

• Wound Care

Work Location: In person